【摘要】 目的探讨3例致上消化道出血Dieulafoy病的发病情况、临床特征、诊断与治疗。方法收集天津市咸水沽医院2000年12月~2009年10月间收治的上消化道出血病人465例,对其中检出的3例Dieulafoy病病例的临床特征、内镜下表现及治疗方法进行回顾性分析。结果 Dieulafoy病约占上消化道出血的0.65%,3例Dieulafoy病中,病灶位于胃体2例,十二指肠球部1例,3例于胃镜下可直接见破裂血管;2例可见喷射状出血。病灶直径2 mm 1例,病灶直径2.5~10 mm 2例。2例病例于内镜下行病灶黏膜下局部注射肾上腺素后无效行内镜下金属钛夹止血,1例内镜治疗无效再出血中转手术治疗。结论 Dieulafoy病是上消化道大出血的少见而重要的病因,该病诊断主要依靠胃镜检查,通过内镜早期诊断和治疗可以取得较好的疗效。内镜治疗无效应及时中转手术治疗。更多还原

【Abstract】 Objective To identify the clinical features and endoscopic management of 3 cases of Dieulafoy’s lesion in the upper gastrointestinal(GI) bleeding,and to review the literature related.Methods The data of 3 cases of Dieulafoy’s lesion out of 465 patients with the upper GI bleeding were reviewed and analyzed retrospectively from December 2000 to October 2009,including the clinical features,the endoscopic examination and the endoscopic therapies.Results 0.65 % of the cases of upper GI bleeding were caused by Dieulafoy’s lesion.Among the 3 cases of Dieulafoy’s lesion,2 in the body of stomach,and one was in the duodenum.Broken blood vessel was found directly in 3 cases.The diameter of the lesion was 2 mm in one case,and 2.5 mm-10 mm in other 2 cases.Two cases were treated with endoscopic hemoclip and two of them were applied with insufflation of fibrin sealant,one case had bleeding and endoscopic ineffective treatment by surgery.Conclusion Dieulafoy’s lesion is an uncommon but major cause for upper gastrointestinal bleeding.Emergent endoscopic examination and therapy in the early stage can be very effective.If endoscopic therapy fails operation must be taken.更多还原